Kuniyoshi Yukio
Department of Thoracic and Cardiovascular Surgery, School of Medicine, University of the Ryukyu, Okinawa, Japan.
Kyobu Geka. 2015 Jul;68(8):576-81.
Although the operative results for non-dissecting thoracic aneurysm has been improving markedly, that of the ruptured one is still poor. Once aneurysmal rupture is occurred, a patient can almost never survive. Only few patients could arrive to an emergency hospital. It is reported that about 60% of the patients are died suddenly and the remaining 40% of the patients may undergo surgery or endovascular intervention. In the annual report in 2012 published by "Journal of General Thoracic and Cardiovascular Surgery", the mortality rates during postoperative 30 days of the non-ruptured and the ruptured nondissecting thoracic aneurysm are 2.71% and 19.0% respectively. Thoracic endovascular aortic repair (TEVAR) is predominant alternatives for the patients with poor hemodynamic condition by rupture of aortic aneurysm. The mortality rate after TEVAR for ruptured thoracic aneurysm is reported to be 10.87%, and is lower than that of the open surgery. It is essential for preventing the death by aneurysmal rupture that the open surgery or TEVAR for thoracic aortic aneurysm should be carried out electively.
尽管非夹层胸主动脉瘤的手术效果有了显著改善，但破裂性胸主动脉瘤的手术效果仍然很差。一旦动脉瘤破裂，患者几乎无一能存活。只有极少数患者能够抵达急诊医院。据报道，约60%的患者会突然死亡，其余40%的患者可能接受手术或血管内介入治疗。在《胸心血管外科杂志》2012年发表的年度报告中，未破裂和破裂性非夹层胸主动脉瘤术后30天的死亡率分别为2.71%和19.0%。对于因主动脉瘤破裂而血流动力学状况不佳的患者，胸主动脉腔内修复术（TEVAR）是主要的替代治疗方法。据报道，破裂性胸主动脉瘤TEVAR术后的死亡率为10.87%，低于开放手术。为防止动脉瘤破裂导致死亡，胸主动脉瘤的开放手术或TEVAR应择期进行。
